Bridges and Barriers to Health: Her Story—Emirati Women's Health Needs

Abstract

Health care services in the United Arab Emirates have developed rapidly in the last 30 years fueled by oil revenues. These services have been planned and provided predominantly by non-nationals, with mixed success. The authors identify aspects of the health care system and the sociocultural environment that create both barriers and bridges to holistic health for Emirati women. Barriers include early/consanguineous marriage, frequent childbearing, polygamy, and care that is lacking in competence and cultural sensitivity. Bridges include Islam, folk medicine, cultural traditions, and the opportunity to travel abroad for health care. Maids are seen as both a barrier and bridge at different times. Recommendations for future improvements include listening to Emirati women and providing more gender-appropriate, holistic, and culturally congruent programs.

Muslim Women's Physician Preference: Beyond Obstetrics and Gynecology

“…We found that the Muslim women in our study, irrespective of their age, marital status, income, and literacy status, almost exclusively requested a female physician for medical conditions involving the awrah, areas of the body required by Islam to be covered, and which Muslim women generally find embarrassing to expose to the opposite gender (Underwood et al, 1999;Winslow & Honein, 2007;Yosef, 2008). Our findings confirm reports of Muslim women's request for same-gender physicians in O&G (Aldeen, 2007;Hammoud et al, 2005;Lafta, 2006;Rizk et al, 2005;Rizk & El-Safty, 2006;Uskul & Ahmad, 2003).…”

“…2002) or in Islamic countries (Lafta, 2006; Downloaded by [New York University] at 00:55 06 October 2014 Rizk et al 2005;Rizk & El-Safty, 2006;Rizk, Nasser, Thomas, & Ezimokhai, 2001;Rizk, Shaheen, Thomas, Dunn, & Hassan, 1999;Uskul & Ahmad, 2003;Winslow & Honein, 2007). Thus, in contexts and communities where culture and religion are deep rooted, a same-gender practitioner is likely to be important for women, particularly for intimate examinations such as breast, obstetric, gynecological, and urogenital examinations (Aldeen, 2007;Matin & LeBaron, 2004;Rajaram & Rashidi, 1999Rizk & El-Safty, 2006;Rizk et al, 2001Rizk et al, , 2005Underwood et al, 1999;Zuckerman et al, 2002).…”

“…While UAE leaders strove to ensure a healthy, modern, and educated society, they have also tried to preserve its cultural traditionalism and religious conservatism, placing considerable emphasis on religion to protect the country's tribal inheritance. Despite considerable social and political changes over the past 4 decades, which have culminated in, for example, Emirati women accounting for 70% of university enrolment (Ridge, 2009) and competing successfully in the labor market (Nelson, 2004), the country's patriarchal ideology persists (Al Seyegh, 2004;Schvaneveldt et al, 2005;Winslow & Honein, 2007). In line with the traditional religious, social, and cultural norms of most Islamic societies (Badawi, 1971), girls have been socialized into the nurturing roles of wife and mother, while males are regarded as breadwinners and may head extended polygamous families (Schvaneveldt et al, 2005;Winslow & Honein, 2007).…”

“…Despite considerable social and political changes over the past 4 decades, which have culminated in, for example, Emirati women accounting for 70% of university enrolment (Ridge, 2009) and competing successfully in the labor market (Nelson, 2004), the country's patriarchal ideology persists (Al Seyegh, 2004;Schvaneveldt et al, 2005;Winslow & Honein, 2007). In line with the traditional religious, social, and cultural norms of most Islamic societies (Badawi, 1971), girls have been socialized into the nurturing roles of wife and mother, while males are regarded as breadwinners and may head extended polygamous families (Schvaneveldt et al, 2005;Winslow & Honein, 2007). In the gendersegregated UAE society, as in other patriarchal societies, men are perceived as the protectors of women who, until recently, had little opportunity to interact outside the family.…”

“…Since failure to take cognizance of patients' cultural and religious perspective may compromise their health (Aldeen, 2007;Rizk & El-Safty, 2006;Underwood et al, 1999;Winslow & Honein, 2007), medical regulatory bodies expect clinicians to be culturally competent, respecting patient autonomy and religious and cultural values (Laird, de Marrais, & Barnes, 2007). If "culture embodies those values, religious, and otherwise, that constitute the background to individuals' health attitudes and behaviors" (Rizk & ElSafty, 2006, p. 436), then the reported resistance of African American and American Muslim immigrant women to breast and cervical cancer screening because these women believed procedures were not consistent with Islamic customs or their beliefs is testimony of the influence of religious and cultural values on health-seeking behavior and ultimately health outcomes (Matin & LeBaron, 2004;Rajaram & Rashidi, 1999Underwood et al, 1999).…”